Diabetologia dziecięca — hospitalizacja w mapach potrzeb zdrowotnych Polski w 2014 roku

Opieka nad chorym na cukrzycę stanowi znaczące wyzwanie dla polityki zdrowotnej z uwagi na stale rosnącą liczbę zachorowań, zarówno w przypadku dorosłych, jak i dzieci. W Polsce opieka szpitalna nad dziećmi chorymi na cukrzycę jest scentralizowana i większość świadczeń realizują szpitale o charakterze uniwersyteckim i wojewódzkim. Mimo to struktura udzielanych świadczeń jest wysoce zróżnicowana pomiędzy województwami, zarówno pod względem liczby hospitalizacji na 100 tys. dzieci, salda migracji, długości pobytu w szpitalu, jak i odsetka hospitalizacji z powodu ostrych powikłań

Dostępność osobistych pomp insulinowych wśród dzieci z cukrzycą w Polsce w 2014 roku

Jednym z głównych aspektów kompleksowej opieki medycznej nad pacjentem z cukrzycą, w szczególności dziećmi, jest dostępność do nowoczesnej technologii — do osobistych pomp insulinowych. W Polsce ubezpieczyciel (Narodowy Fundusz Zdrowia) poprzez świadczenie odrębnie kontraktowane refunduje dzieciom zestawy infuzyjne do osobistej pompy insulinowej. Struktura udzielanych świadczeń jest bardzo zróżnicowana pomiędzy województwami pod względem dostępności do pomp insulinowych

Diabetes as a risk factor of death in hospitalized COVID-19 patients – an analysis of a National Hospitalization Database from Poland, 2020

IntroductionDiabetes is one of the comorbidities associated with poor prognosis in hospitalized COVID-19 patients. In this nationwide retrospective study, we evaluated the risk of in-hospital death attributed to diabetes.MethodsWe analyzed data from discharge reports of patients hospitalized with COVID-19 in 2020 as submitted to the Polish National Health Fund. Several multivariate logistic regression models were used. In each model, in-hospital death was estimated with explanatory variables. Models were built either on the whole cohorts or cohorts matched with propensity score matching (PSM). The models examined either the main effects of diabetes itself or the interaction of diabetes with other variables.ResultsWe included 174,621 patients with COVID-19 who were hospitalized in the year 2020. Among them, there were 40,168 diabetic patients (DPs), and the proportion of DPs in this group was higher than in the general population (23.0% vs. 9.5%, p<0.001). In this group of COVID-19 hospitalizations, 17,438 in-hospital deaths were recorded, and the mortality was higher among DPs than non-diabetics (16.3% vs. 8.1%, p<0.001). Multivariate logistic regressions showed that diabetes was a risk factor of death, regardless of sex and age. In the main effect analysis, odds of in-hospital death were higher by 28.3% for DPs than for non-diabetic patients. Similarly, PSM analysis including 101,578 patients, of whom 19,050 had diabetes, showed that the risk of death was higher in DPs regardless of sex with odds higher by 34.9%. The impact of diabetes differed among age groups and was the highest for patients aged 60-69.ConclusionsThis nationwide study confirmed that diabetes was an independent risk factor of in-hospital death in the course of COVID-19 infection. However, the relative risk differed across the age groups

Occurrence, Trends, Management and Outcomes of Patients Hospitalized with Clinically Suspected Myocarditis—Ten-Year Perspectives from the MYO-PL Nationwide Database

The epidemiology of myocarditis is unknown and based mainly on small single-centre studies. The study aimed to evaluate the current incidence, clinical characteristics, management and outcomes of patients hospitalized due to myocarditis in a general population. The study was registered in ClinicalTrials.gov (NCT04827706). The nationwide MYO-PL (the occurrence, trends, management and outcomes of patients with myocarditis in Poland) database (years 2009–2020) was created to identify hospitalization records with a primary diagnosis of myocarditis according to the International Classification of Diseases and Related Health Problems, 10th Revision (ICD 10), derived from the database of the national healthcare insurer. We identified 19,978 patients who were hospitalized with suspected myocarditis for the first time, of whom 74% were male. The standardized incidence rate of myocarditis ranged from 1.15 to 14 per 100,000 people depending on the age group and was the highest in patients aged 16–20 years. The overall incidence increased with time. The performance of the recommended diagnostic tests (in particular, endomyocardial biopsy) was low. Relative five-year survival ranged from 0.99 to 0.56—worse in younger females and older males. During a five-year follow-up, 6% of patients (3.7% and 6.9% in females and males, respectively) were re-hospitalized for myocarditis. Surprisingly, females more frequently required hospitalization due to heart failure/cardiomyopathy (10.5%) and atrial fibrillation (5%) than compared to males (7.3% and 2.2%, respectively) in the five-year follow up. In the last ten years, the incidence of suspected myocarditis increased, particularly in males. Survival rates for patients with myocarditis were worse than in the general population. Management of myocarditis requires significant improvement

Sex Differences in Incidence, Clinical Characteristics and Outcomes in Children and Young Adults Hospitalized for Clinically Suspected Myocarditis in the Last Ten Years—Data from the MYO-PL Nationwide Database

There is a widespread lack of systematic knowledge about myocarditis in children and young adults in European populations. The MYO-PL nationwide study aimed to evaluate sex differences in the incidence, clinical characteristics, management and outcomes of all young patients with a clinical diagnosis of myocarditis, hospitalized in the last ten years. The study involved data (from the only public healthcare insurer in Poland) of all (n = 3659) patients aged 0–20 years hospitalized for myocarditis in the years 2011–2019. We assessed clinical characteristics, management and five-year outcomes. Males comprised 75.4% of the study population. The standardized incidence rate of myocarditis increased over the last ten years and was, on average, 7.8 and 2.5 (in males and females, respectively). It was the highest (19.5) in males aged 16–20 years. The highest rates of hospital admissions occurred from late autumn to early spring. Most myocarditis-directed diagnostic procedures, including laboratory tests, echocardiography, coronary angiography, cardiac magnetic resonance and endomyocardial biopsy, were performed in a low number of patients, particularly in females. Most patients required rehospitalization for cardiovascular reasons. The results of this large epidemiological study showed an increasing incidence of myocarditis hospitalizations in young patients over last ten years and that it was sex-, age- and season-dependent. Survival in young patients with myocarditis was age- and sex-related and usually it was worse than in the national population. The general management of myocarditis requires significant improvement

Accessibility to personal insulin pumps among children with diabetes mellitus in Poland in 2014

One of the principal aspects of comprehensive medical care for patients with diabetes mellitus, especially paediatric patients, is the accessibility to personal insulin pumps. In Poland, the National Health Fund secures personal insulin pumps for children by means of a separately commissioned service. The structure of the provided services varies greatly from province to province in terms of accessibility to insulin pumps

Paediatric diabetes care: inpatient care in the Maps of Health Needs of Poland in 2014

Health care provision for patients with diabetes mel­litus is a considerable challenge to health policy due to the increasing number of its new cases, both in adults and in children. In Poland, hospital care for children with diabetes mellitus is centralized and most services are provided by university and provincial hospitals. In spite of the above the structure of the services provided varies widely from province to province, both in terms of the number of hospitalizations per 100,000 children, net migration rate, length of hospital the stay, and percentage of hospitalizations for acute complications. It is necessary to improve the societal and medi­cal awareness regarding the signs and symptoms of diabetes in order to reduce the number of acute complications, including those at the time of diagno­sis. Furthermore, it is crucial to make every effort to provide equal access to specialist diabetes care, thus to make it consistent with the standards. The high number and differences in the numbers, duration of hospitalizations of children with diabetes require further monitoring at a coordinated system of pediatric care.Provision of care to patients with diabetes mellitus is a considerable challenge to health policy due to the increasing number of new cases, both in adults and in children. In Poland, hospital care provided to children with diabetes mellitus is centralised and most services are provided by university and provincial hospitals. In spite of the above the structure of the services provided varies widely from province to province, both in terms of the number of hospitalisations per 100,000 children, net migration rate, length of stay, and percentage of hospitalisations for acute complications